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Junior doctors will begin a four-day strike today as an NHS leader warns up to 350,000 appointments, including operations, could be cancelled.

The walkout by up to 47,600 junior doctors is part of a worsening pay dispute which threatens huge disruption to the NHS.

The strikes centre around a pay row between the British Medical Association (BMA) and the government.

The BMA, the doctors’ union, says junior doctors in England have seen a 26% real-terms pay cut since 2008/09 because pay rises have been below inflation.

The union has asked for a full pay restoration that the government said would amount to a 35% pay rise – which ministers have said is unaffordable.

Junior doctors will mount picket lines outside hospitals from 7am until Saturday morning in the longest walkout since nurses, ambulance crews and other health workers started taking action in 2022.

Matthew Taylor, chief executive of the NHS Confederation, has told Sky News he expects “up to 350,000 appointments” to be cancelled as a result of the four-day action.

Meanwhile, NHS managers have warned that patient care is “on a knife edge” over the next four days because of the strike.

The BMA has released an advert which shows how much doctors with 10, seven and one-years experience would earn for completing an operation where an appendix is removed.

The advert says they would earn £28, £24.46, and £14.09 respectively – a total of £66.55 for a potentially life-saving procedure.

‘My dad is telling me to quit’

Dr Jennifer Barclay, a surgical doctor in the North West, said: “I’ll be working a busy on-call shift; treating unwell patients, assessing new patients, consenting and preparing patients for surgery and answering never ending bleeps, when we have to run to theatre.

“I haven’t had time to eat or nip to the loo and I know I’ll be in theatre for around an hour. An appendicectomy like the one in this advert would be a typical case.

“I want the doctors treating my loved ones to be well rested and able to provide the best care possible.

“I don’t want them to be burnt out, worried about paying the bills or up to £100,000 of debt or thinking about alternative careers whilst making life and death decisions.

“My dad, an electrician, tells me to quit and retrain in his footsteps; I’d be earning more, have less stress, less responsibility, better hours and a better work-life balance after three years.”

Read more:
Why this could be the worst NHS strike yet

Junior doctors at a picket line outside St Thomas' Hospital in Westminster in March. Pic: AP
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Junior doctors at a picket line outside St Thomas’ Hospital in Westminster in March. Pic: AP

Dr Robert Laurenson and Dr Vivek Trivedi, BMA junior doctors committee co-chairs, said: “It is appalling that this government feels that paying three junior doctors as little as £66.55 between them for work of this value, is justified.

“This is highly skilled work requiring years of study and intensive training in a high-pressure environment where the job can be a matter of life and death.”

Pay rise demand is ‘unreasonable’

Health Secretary Steve Barclay said: “It is extremely disappointing the BMA has called strike action for four consecutive days.

“Not only will the walkouts risk patient safety, but they have also been timed to maximise disruption after the Easter break.

“I hoped to begin formal pay negotiations with the BMA last month but its demand for a 35% pay rise is unreasonable – it would result in some junior doctors receiving a pay rise of over £20,000.

“If the BMA is willing to move significantly from this position and cancel strikes we can resume confidential talks and find a way forward, as we have done with other unions.”

Read more:
Emergency and urgent care to be prioritised during junior doctors’ strike
‘Militant’ junior doctors accused of seeking ‘maximum disruption’

Mr Barclay also said people should attend appointments unless told otherwise by the NHS. He added they should also call 999 in a life-threatening emergency and use NHS 111 online services for non-urgent health needs.

Meanwhile, Mr Taylor told Sky News: “These strikes are going to have a catastrophic impact on the capacity of the NHS to recover.

“The health service has to meet high levels of demand at the same time as making inroads into that huge backlog… That’s a tough thing to do at the best of times – it’s impossible to do when strikes are continuing.”

Asked whether everyone who needs urgent care this week will get it, he said: “We hope so.

“There’s no point hiding the fact that there will be risks to patients, risks to patient safety, risks to patient dignity, as we’re not able to provide the kind of care that we want to.”

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‘Strikes going to have catastrophic impact’

Patients ‘crying out for leadership’

Shadow health secretary Wes Streeting said : “The junior doctors’ strike this week will cause huge disruption to patient care.

“Where is the Prime Minister and why hasn’t he tried to stop it?

“Rishi Sunak says he ‘wouldn’t want to get in the middle of’ NHS pay disputes.

“Patients are crying out for leadership, but instead they are getting weakness.”

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UK must prepare for 2C of warming by 2050, government told for first time

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UK must prepare for 2C of warming by 2050, government told for first time

Britain must prepare for at least 2C of warming within just 25 years, the government has been advised by its top climate advisers.

That limit is hotter and sooner than most of the previous official advice, and is worse than the 1.5C level most of the world has been trying to stick to.

What is the 1.5C temperature threshold?

Under the 2015 Paris Agreement, countries agreed to try to limit warming to “well below” 2C – and ideally 1.5C.

But with global average temperatures already nearing 1.4C, warnings that we may have blown our chances of staying at 1.5C have been growing.

This new warning from the government’s top advisers, the independent Climate Change Committee (CCC), spells out the risk to the UK in the starkest terms yet.

In a letter today, the CCC said ministers should “at a minimum, prepare the country for the weather extremes that will be experienced if global warming levels reach 2C above pre-industrial levels by 2050”.

It is the first time the committee has recommended such a target, in the hopes of kickstarting efforts to make everything from flooded train tracks to sweltering classrooms more resilient in a hotter world – after years of warnings the country is woefully unprepared.

Periods of drought in England are expected to double at 2C of global warming, compared to the recent average period of 1981 to 2010. Pic: PA
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Periods of drought in England are expected to double at 2C of global warming, compared to the recent average period of 1981 to 2010. Pic: PA

How climate change affects the UK

The UK is already struggling to cope with the drought, flooding, and heat brought by the current 1.4C – “let alone” what is to come, the advisers said.

Just this year, the country battled the second-worst harvest on record and hottest summer ever, which saw an extra 300 Londoners die.

“Though the change from 1.5C and 2C may sound small, the difference in impacts would be substantial,” CCC adviser Professor Richard Betts told Sky News.

It would mean twice as many people at risk of flooding in some areas, and in southern England, 10 times as many days with a very high risk of wildfires – an emerging risk for Britain.

The experts said the mass building the government is currently pushing, including new nuclear power stations and homes, should even be adaptable for 4C of warming in the future – a level unlikely, but which cannot be ruled out.

At 2C, peak average rainfall in the UK is expected to increase by up to 10–15% for the wettest days. Pic: Reuters
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At 2C, peak average rainfall in the UK is expected to increase by up to 10–15% for the wettest days. Pic: Reuters

Is it too late to stop climate change or limit to 1.5C?

The CCC’s Baroness Brown said in a briefing: “We continue to believe 1.5C is achievable as a long-term goal.

“But clearly the risk it will not be achieved is getting higher, and for risk management we do believe we have to plan for 2C.”

World leaders will discuss their plans to adapt to hotter temperatures at the COP30 climate summit in Brazil in November.

Professor Eric Wolff, who advises the Royal Society, said leaders needed to wake up.

“It is now very challenging even to stay below two degrees,” he told Sky News.

“This is a wake-up call both to continue reducing emissions, but at the same time to prepare our infrastructure and economy for the inevitable climate changes that we are already committed to.”

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Premier League players to take knee for first time this season

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Premier League players to take knee for first time this season

Premier League chief executive Richard Masters has told Sky News players will take the knee at this weekend’s matches amid ongoing discussions about whether the anti-racism move is still effective.

Captains of the 20 clubs are understood to back the move, although players could decide individually to opt out.

The majority of Women’s Super League teams recently decided against taking the knee in games marking Black History Month, feeling it was no longer meaningful amid a rise in racism.

Arsenal's Declan Rice takes the knee in a match last season. Pic: Reuters
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Arsenal’s Declan Rice takes the knee in a match last season. Pic: Reuters

Sky News revealed last week that online racism cases in English football have quadrupled this season.

And in his exclusive interview, Mr Masters raised concerns about the anonymity of social media users posting abuse and questioned whether identity checks were now necessary.

The Premier League wants platforms to do more to change algorithms to stop players seeing the abuse, and to introduce additional protections to stop it reaching their inboxes.

Football frames racism as a societal problem – requiring education – and Sky News accompanied Mr Masters on a school visit in west London, where the Premier League linked up with Brentford.

Premier League chief executive Richard Masters
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Premier League chief executive Richard Masters

Taking the knee

This weekend’s matches will highlight the league’s “No Room for Racism” campaign to combat discrimination and promote equality.

It was in 2020, inspired by the Black Lives Matter movement, that Premier League players started to take the knee before kick-off.

But questions about the effectiveness of the gesture have grown.

“It’s always been their choice,” Mr Masters told Sky News of the players. “It’s never been something that has been forced upon them, either collectively or individually. They had another discussion in the summer.

“They’re going to do it really at the No Room for Racism match rounds. We then decide whether they want to continue or stop. So I think they want to make sure whatever they do, it’s effective.”

The Premier League's 'No room for racism' campaign has adorned team kits. Pic: PA
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The Premier League’s ‘No room for racism’ campaign has adorned team kits. Pic: PA

‘You’ll be dealt with’

This is a season that began with Bournemouth’s Antoine Semenyo reporting being racially abused at Liverpool, although Mr Masters said “the protocols worked”.

He added: “A lot of our players and participants, managers, referees are subject to abuse, a lot of it racism.

“And we’re trying our best to deal with that, working with our stakeholders and working with the social media companies to try to solve those issues.”

Bournemouth's Antoine Semenyo (left) was racially abused at Anfield this season. Pic: PA
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Bournemouth’s Antoine Semenyo (left) was racially abused at Anfield this season. Pic: PA

For the league, that is not symptomatic of racist abuse becoming more prevalent in stadiums.

“The Premier League is a very permissive environment,” Mr Masters said. “Very few other places you can come and scream and shout and support your team.

“But I think that fans know where that line is. No violence, no threatened intimidation, and no discrimination. If you do, then you’ll be dealt with.”

Polarised society

The political climate can become problematic, although Mr Masters does not directly reference the summer’s anti-immigration protests when asked.

“Those are political issues, and I think that football’s role is to provide that distraction,” he said.

“Football stands slightly to the side to where society is at the moment, where we are seeing a little bit of polarisation of views. Football, I think, can help in that aspect.”

Semenyo has been one of this campaign's star perfomers. Pic: PA
Image:
Semenyo has been one of this campaign’s star perfomers. Pic: PA

Social media anonymity

Too many feel they can hurl racist abuse at footballers on social media – and Mr Masters insists the league is “very restless” about eradicating that.

Greater identity checks could help.

Mr Masters said: “There’s an anonymity to it, I think, which, perhaps wrongly, in my view, gives people the view that they can pretty much say and do what they want.

“And I just simply don’t think it should be part of a professional footballer’s life to have to put up with this sort of stuff, which is why we’re taking what action we can.

“Obviously, anything that makes it easier [to find the perpetrators] I would be in principle supportive of, but I think it goes to a lot of other issues around freedom of information.”

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Football sees surge in online hate

AI and algorithms

There is a unit at the Premier League dedicated to pursuing social media firms over racist abuse, which has no complaints publicly about the conduct of the tech giants.

But the league’s director of content protection, Tim Cooper, told Sky News: “The platforms can do more by changing their algorithms, looking at the opting in to see abuse rather than perhaps opting out of seeing it. That would be a step in the right direction.

“And ultimately, it’s for us to keep trying to push cases through and get good real-world deterrent actions, alongside law enforcement and other enforcement bodies around the world.”

There are concerns about the use of AI to create racist images and abusers using phrases or jumbled letters to circumvent algorithms.

Read more from Sky News:
England qualify for 2026 World Cup

Why has the weather been gloomy recently

“It’s very much gone beyond just a text rant now, which is obviously bad enough, but now we’re seeing that people are using images to create some of the most offensive things that you could imagine,” Mr Cooper said.

“I think video will be something in the future going forward that could be a problem, and we have seen that with deepfakes.”

Instagram owner Meta and Elon Musk‘s X both said they would not provide detail about any work to eradicate racism – declining months of requests for interviews.

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FA considering social media boycott over racism

Being on social media means children are more aware than ever of incidents of racist abuse across football.

After leading the class in west London, Premier League Primary Stars coordinator Benjamin Abrahams said: “Having to speak to young pupils about things they’ve heard, things they know about, can sometimes be tough.

“But actually, it’s a great chance to speak to them and have those open conversations. To discuss why things are said, why things happen, but [why] it’s not right, and be able to discuss what is correct and what should we all hope for.”

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Deadline day for firm linked to Tory peer to pay back millions over COVID contract scandal

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Deadline day for firm linked to Tory peer to pay back millions over COVID contract scandal

Today is the High Court’s deadline for a firm linked to Baroness Michelle Mone to repay £122m for supplying defective PPE at the height of the pandemic, with no indication the Department of Health and Social Care (DHSC) will be paid in full.

PPE Medpro, the company founded by her husband Doug Barrowman and introduced to a “VIP lane” for providers by the Conservative peer, has until 4pm to make the payment.

While Mr Barrowman has described himself as the “ultimate beneficial owner” of PPE Medpro, and says £29m of profit from the deal was paid into a trust benefitting his family, including Baroness Mone and her children, he was never a director and the couple are not personally liable for the money.

PPE Medpro filed for insolvency the day before Mrs Justice Cockerill’s finding of breach of contract was published, and the company’s most recent accounts show assets of just £666,000.

Court-appointed administrators will now be responsible for recovering as much money as possible on behalf of creditors, principally the DHSC.

Last week, Mr Barrowman’s spokesman said “consortium partners” of PPE Medpro are “prepared to enter into a dialogue with the administrators of the company to discuss a possible settlement with the government”.

Read more:
The PPE scandal surrounding Michelle Mone explained

Baroness Mone recommended the firm, led by husband Doug Barrowman, to ministers. Pic: PA
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Baroness Mone recommended the firm, led by husband Doug Barrowman, to ministers. Pic: PA

Sky News understands the consortium met last week and has contacted the administrators to request they facilitate a negotiation with the government.

Mr Barrowman’s spokesman did not specify how much they would be willing to offer by way of settlement, but in June PPE Medpro offered to settle the case for £23m.

The DHSC rejected that offer, but with the company in administration and potentially limited avenues to recover funds, there is a risk the government may recover nothing while incurring further legal expenses.

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Mone should ‘resign’

What happened during the pandemic?

In June 2020, PPE Medpro won contracts worth a total of £203m to provide 210 million masks and 25 million surgical gowns after Baroness Mone contacted ministers, including Michael Gove, on the company’s behalf.

While the £81m mask contract was fulfilled, the gowns were rejected for failing sterility standards, and in 2022 the DHSC sued. Earlier this month, Mrs Justice Cockerill ruled PPE Medpro was in breach of contract and liable to repay the full amount.

Mr Barrowman has previously named several other companies as part of the gown supply, including two registered in the UK, and last week his spokesman said there was a “strong case” for the administrator to pursue them for the money.

One of the companies named has denied any connection to PPE Medpro and two others have not responded to requests for comment.

What could government do about it?

Insolvency experts say administrators and creditors, in this case the government, may have some recourse to pursue individuals and entities beyond the liable company, but any process is likely to be lengthy and expensive.

Julie Palmer, a partner at Begbies Traynor, told Sky News: “The administrators will want to look at what’s happened to what look like significant profits made on these contracts.

“If I was looking at this, I would want to establish the exact timeline, at what point were the profits taken out.

“They may also want to consider whether there is a claim for wrongful trading, because that effectively pierces the corporate veil of protection of a limited company, and can allow proceedings against company officers personally.

“The net of a director can also be expanded to shadow directors, people sitting in the background quite clearly with a degree of control of the management of the company, in which case some claims may rest against them.”

A spokesman for Forvis Mazars, one of the joint administrators of PPE Medpro, did not comment other than to confirm the firm’s appointment.

The DHSC was approached for comment.

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